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A 46-year-old woman with multiple myeloma presented with hoarseness and a painful sensation while swallowing. She had undergone autologous stem-cell transplantation five years earlier and was receiving daratumumab, pomalidomide, and dexamethasone. A laryngoscopy revealed an exophytic mass with friable mucosa affecting the epiglottis, aryepiglottic fold, and false vocal fold.
Histopathological examination confirmed encapsulated yeast forms, identified as Cryptococcus neoformans. Additional testing revealed high cryptococcal antigen titers in her serum and cerebrospinal fluid (CSF), leading to the diagnosis of disseminated cryptococcosis with laryngeal involvement. Laryngeal cryptococcal infections are rare and usually result from hematogenous spread or direct inhalation of fungal organisms.
Following antifungal therapy, symptoms resolved within one month, and a repeat laryngoscopy showed complete regression of the lesion.